Family and care of psychiatric patients

sporina · 24-05-2021 6:05pm #1

On the back of the McGinley tragedy, this is being debated a lot on the airwaves now.. just wondering what people's thoughts are on it?

https://www.irishtimes.com/news/social-affairs/changes-needed-in-treatment-of-parents-with-mental-health-issues-says-una-butler-1.4573883

lazygal · 24-05-2021 6:43pm

I don't know how you mandate family involvement without breaking the right of a patient to confidentiality. There's enough stigma around mental health without the worry that your next of kin would get a heads up about your mental illness and treatment plan.
And some people don't want their families involved in their care for very, very good reasons.

Tom Mann Centuria · 24-05-2021 6:49pm

A terrible tragedy but you just cannot do what she is asking.

24-05-2021 6:50pm

^^^^ yes.

Nieve and simplistic

Spanish Eyes · 24-05-2021 7:00pm

No bother to the Health Service to discharge people to their families to care for them with little support, (mental or physical illness). Surely if you are to be the carer of someone who is ill you should have input into their care and know what you are dealing with.

I do understand the confidentiality angle, but there is a balance out there somewhere. I suppose the fear of a family sectioning someone for nefarious reasons is at the back of some people's minds, but many leave their elderly ill in hospital for the HSE to organise their care.

An independent advocate unconnected with the HSE or the family maybe? Wards of Court? I dunno, it's a very difficult subject, but if some change saved lives it would be worth investigating.

freshpopcorn · 24-05-2021 7:09pm

I simply don't understand how this will work due to Dr patient confidently.
Apart from people being less inclined to talk in front of family members and them I also feel partners/parents could really manipulate a situation.

lazygal · 24-05-2021 7:45pm

Spanish Eyes wrote: »

No bother to the Health Service to discharge people to their families to care for them with little support, (mental or physical illness). Surely if you are to be the carer of someone who is ill you should have input into their care and know what you are dealing with.

I do understand the confidentiality angle, but there is a balance out there somewhere. I suppose the fear of a family sectioning someone for nefarious reasons is at the back of some people's minds, but many leave their elderly ill in hospital for the HSE to organise their care.

An independent advocate unconnected with the HSE or the family maybe? Wards of Court? I dunno, it's a very difficult subject, but if some change saved lives it would be worth investigating.

If people cannot care for someone at home they need to refuse to act as a carer. I know families who refused to agree to an elderly person being discharged to their care because the necessary home care packages and other supports weren't in place.
I'm not a nurse. Or a psychiatrist. I couldn't agree to act as one for anyone and I would be **** at the job.

Mad_maxx · 24-05-2021 7:48pm

too much concern about human rights ( in an ideological sense ) and not enough about life and death reality

of course the families of someone who is a danger to themselves and others should be given powers

the culture which prevails amongst psychiatry today is riddled with liberalism and believes taking away someones freedom is a worse situation than that person committing murder

we threw the baby out with the bathwater when we closed down the old institutions , the much lauded Mary Raftery done a lot of harm yet was treated as a hero by the likes of RTE , it is far far too hard to get someone committed against their will and innocent people die as a result

lazygal · 24-05-2021 7:51pm

Women with post natal depression used to be locked up. In fact any troublesome family member could be locked up on the word of a psychiatrist who would take the opinion of the man of the household. We can't go back to having mass incarceration for mental illness.

Mad_maxx · 24-05-2021 7:52pm

lazygal wrote: »

Women with post natal depression used to be locked up. In fact any troublesome family member could be locked up on the word of a psychiatrist who would take the opinion of the man of the household. We can't go back to having mass incarceration for mental illness.

we dont need to do that but the pendulum completely swung the other way

lazygal · 24-05-2021 7:53pm

Mad_maxx wrote: »

we dont need to do that but the pendulum completely swung the other way

No it didn't. It was always inappropriate to have people committed to institutions rather than develop more appropriate care pathways.

sporina · 24-05-2021 7:55pm

lazygal wrote: »

If people cannot care for someone at home they need to refuse to act as a carer. I know families who refused to agree to an elderly person being discharged to their care because the necessary home care packages and other supports weren't in place.
I'm not a nurse. Or a psychiatrist. I couldn't agree to act as one for anyone and I would be **** at the job.

no offence but you are not comparing like with like, with the above...

we are talking about when there is a situation by where the patient/relative is a potential harm to themselves or someone else..

freshpopcorn · 24-05-2021 7:56pm

lazygal wrote: »

Women with post natal depression used to be locked up. In fact any troublesome family member could be locked up on the word of a psychiatrist who would take the opinion of the man of the household. We can't go back to having mass incarceration for mental illness.

I've a relative who honestly thinks if you have a relative who's depressed you just bring the person to faciality and you get them locked up for a while because that's what it used be like.

lazygal · 24-05-2021 7:57pm

sporina wrote: »

no offence but you are not comparing like with like, with the above...

we are talking about when there is a situation by where the patient/relative is a potential harm to themselves or someone else..

That still doesn't mean someone's medical details legally have to be shared with anyone but their medical team.

lazygal · 24-05-2021 7:58pm

freshpopcorn wrote: »

I've a relative who honestly thinks if you have a relative who's depressed you just bring the person to faciality and you get them locked up for a while because that's what it used be like.

Some people still think a "nursing home" deals with all sorts of illness.

sporina · 24-05-2021 8:06pm

lazygal wrote: »

That still doesn't mean someone's medical details legally have to be shared with anyone but their medical team.

I didn't say it did..

Mad_maxx · 24-05-2021 8:10pm

lazygal wrote: »

No it didn't. It was always inappropriate to have people committed to institutions rather than develop more appropriate care pathways.

broad brush statement , the reality is some people are deeply unwell and its the kinder act to them and everyone else to put them in a controlled environment

that poor woman who was found not guilty by insanity last week , had she been committed , she would simply be a patient in a hospital , now she will be remembered as something else which is a tragedy for her and obviously her husband and children

AndrewJRenko · 24-05-2021 8:13pm

Mad_maxx wrote: »

broad brush statement , the reality is some people are deeply unwell and its the kinder act to them and everyone else to put them in a controlled environment

that poor woman who was found not guilty by insanity last week , had she been committed , she would simply be a patient in a hospital , now she will be remembered as something else which is a tragedy for her and obviously her husband and children

Unless psychiatrists have a crystal ball, they won't be able to predict the future.

If you want to reduce the chances of this stuff happening, make sure people get proper treatment.

Mad_maxx · 24-05-2021 8:23pm

AndrewJRenko wrote: »

Unless psychiatrists have a crystal ball, they won't be able to predict the future.

If you want to reduce the chances of this stuff happening, make sure people get proper treatment.

first things first is to head off a horrific event taking place , after that treatment which ensures a return to normality can begin

as i said earlier , the ideology of human rights is seen as more important than human beings wellbeing

these tragic events are becoming tedious in their pattern , families begging for their loved ones unwell situation to be taken serious and nothing is done ( or apparently can be done ) until a disaster takes place

AndrewJRenko · 24-05-2021 8:33pm

Mad_maxx wrote: »

first things first is to head off a horrific event taking place , after that treatment which ensures a return to normality can begin

as i said earlier , the ideology of human rights is seen as more important than human beings wellbeing

these tragic events are becoming tedious in their pattern , families begging for their loved ones unwell situation to be taken serious and nothing is done ( or apparently can be done ) until a disaster takes place

Great - can we lock up every speeding driver on the road too, to head off horrific events taking place?

lazygal · 24-05-2021 8:35pm

AndrewJRenko wrote: »

Great - can we lock up every speeding driver on the road too, to head off horrific events taking place?

Maybe we shouldn't let women who've given birth home until they can prove they don't have post natal depression or psychosis.

Mad_maxx · 24-05-2021 8:45pm

AndrewJRenko wrote: »

Great - can we lock up every speeding driver on the road too, to head off horrific events taking place?

Don't be obtuse

AndrewJRenko · 24-05-2021 9:19pm

Mad_maxx wrote: »

Don't be obtuse

Far more people are killed on the road than murdered by psychiatric patients. So if we really want to save lives with this preventative approach, why can't we lock up all speeding drivers?

Or are they not quite vulnerable enough to be locked up?

Amirani · 24-05-2021 9:26pm

Mad_maxx wrote: »

Don't be obtuse

You did say that "the ideology of human rights is seen as more important than human beings wellbeing". Do you cherry pick the areas where safety/wellbeing of people trumps human rights and freedoms to do what they want? When in a car, human rights more important. When you have a mental health condition, wellbeing of others more important...

On the specific suggestions, I don't see how you can have a blanket legal requirement that spouses have a right to detailed information and involvement in a patient's care. It's already the case that if children are at risk, then doctors will breach confidentiality to ensure their safety. Can't always be 100% though.

sporina · 24-05-2021 9:29pm

oh gosh.. i think I shudda posted this thread in the legal forum

Mad_maxx · 24-05-2021 9:32pm

AndrewJRenko wrote: »

Far more people are killed on the road than murdered by psychiatric patients. So if we really want to save lives with this preventative approach, why can't we lock up all speeding drivers?

Or are they not quite vulnerable enough to be locked up?

and more people die due to alcoholism

any more examples of whatabouterry ?

Mad_maxx · 24-05-2021 9:36pm

Amirani wrote: »

You did say that "the ideology of human rights is seen as more important than human beings wellbeing". Do you cherry pick the areas where safety/wellbeing of people trumps human rights and freedoms to do what they want? When in a car, human rights more important. When you have a mental health condition, wellbeing of others more important...

On the specific suggestions, I don't see how you can have a blanket legal requirement that spouses have a right to detailed information and involvement in a patient's care. It's already the case that if children are at risk, then doctors will breach confidentiality to ensure their safety. Can't always be 100% though.

the poster is erroneously conflating two entirely different situations in order to make a bogus point

the current system is too concerned about the liberty of those who are a real risk to themselves and those most closest to them , extreme aversion to incarceration trumps everything

lazygal · 24-05-2021 9:38pm

Mad_maxx wrote: »

the poster is erroneously conflating two entirely different situations in order to make a bogus point

the current system is too concerned about the liberty of those who are a real risk to themselves and those most closest to them , extreme aversion to incarceration trumps everything

How do you propose to breach doctor patient confidentiality in the case of mental illness?

AndrewJRenko · 24-05-2021 9:42pm

Mad_maxx wrote: »

the poster is erroneously conflating two entirely different situations in order to make a bogus point

the current system is too concerned about the liberty of those who are a real risk to themselves and those most closest to them , extreme aversion to incarceration trumps everything

Like your extreme aversion to incarceration of speeding drivers?

Yes, they are absolutely different situations, but maybe you could explain why it's OK to lock up people with mental illness to avoid possible future deaths but not OK to lock up speeding drivers to avoid possible future deaths?

Mad_maxx · 24-05-2021 9:47pm

AndrewJRenko wrote: »

Like your extreme aversion to incarceration of speeding drivers?

Yes, they are absolutely different situations, but maybe you could explain why it's OK to lock up people with mental illness to avoid possible future deaths but not OK to lock up speeding drivers to avoid possible future deaths?

strawman

Wanderer78 · 25-05-2021 7:30am

Our mental health services are atrocious and require a substantial investment immediately, this wont occur so nothing is going to change

25-05-2021 7:55am

Mad_maxx wrote: »

strawman

I'm not sure if you can say that given that your argument to start with was terrible... You attributed blame for the failure of our mental health services on Mary Raftery for exposing large scale child abuse. It just has absolutely nothing to do with this...

In this specific case, the woman sought help. Our mental health services failed. Our services are poor by an international standard. That is not an excuse to bring back institutions that basically threw away the key on vulnerable people and ignored their existence as best they could.

WrenBoy · 25-05-2021 8:16am

Our mental health services are a disgrace, the people who work in it are doing their best but there simply isn't enough of them and there seems to be no interest in investing in the area.
https://www.irishtimes.com/news/health/do-i-have-to-lose-her-for-them-to-realise-says-mother-of-anorexic-girl-13-over-lack-of-specialist-bed-1.4563363

This is why I have a problem with government vanity projects and huge investment in projects to make us look like great little boys to the EU whilst vulnerable people here are left to suffer.

25-05-2021 8:16am

sporina wrote: »

oh gosh.. i think I shudda posted this thread in the legal forum

You can ask the mods to move it if you want. But being there doesn't guarantee that you will only get qualified responses especially givetn he basis of the threads discussion point will still attract the same posters who normally can be found moaning about feminists etc in any forum.

Mad_maxx · 25-05-2021 8:27am

Deleted User wrote: »

I'm not sure if you can say that given that your argument to start with was terrible... You attributed blame for the failure of our mental health services on Mary Raftery for exposing large scale child abuse. It just has absolutely nothing to do with this...

In this specific case, the woman sought help. Our mental health services failed. Our services are poor by an international standard. That is not an excuse to bring back institutions that basically threw away the key on vulnerable people and ignored their existence as best they could.

I was referring to how Mary raftery made docus about mental institutions and instilled a narrative that nobody should ever be sent there

Some people are better off in places like that, it's unfortunate but some people need to be in a controlled environment, they are that much of a danger

25-05-2021 8:50am

Mad_maxx wrote: »

I was referring to how Mary raftery made docus about mental institutions and instilled a narrative that nobody should ever be sent there

Some people are better off in places like that, it's unfortunate but some people need to be in a controlled environment, they are that much of a danger

And we were locking up people who shouldn't have been locked up. On top of that, we were keeping those people in atrocious conditions. So ya, I think most would agree that Raftery exposing that was ultimately a good thing. We had the highest number of people in mental institutions in the globe... They were not all unfit for the world, we just have a history of locking people up. Be it in institutions or mother and baby homes. It never addressed the issue and no doubt factors into mental illness being viewed as a taboo in the country.

Mad_maxx · 25-05-2021 10:43am

Deleted User wrote: »

And we were locking up people who shouldn't have been locked up. On top of that, we were keeping those people in atrocious conditions. So ya, I think most would agree that Raftery exposing that was ultimately a good thing. We had the highest number of people in mental institutions in the globe... They were not all unfit for the world, we just have a history of locking people up. Be it in institutions or mother and baby homes. It never addressed the issue and no doubt factors into mental illness being viewed as a taboo in the country.

Nobody has advocated for a repeat of what went before, we threw the baby out with the bathwater however

sporina · 25-05-2021 12:57pm

DubInMeath wrote: »

You can ask the mods to move it if you want. But being there doesn't guarantee that you will only get qualified responses especially givetn he basis of the threads discussion point will still attract the same posters who normally can be found moaning about feminists etc in any forum.

thanks... yeah or was thinking maybe the health issues forum... might get a better audience there,.

Ellie2008 · 25-05-2021 10:57pm

Its a very difficult one. On the one hand it could prevent self harm or harm to others, on the other does it risk those things by forcing a vulnerable person to have a family member involved in their care when it may not be what they want or indeed what’s in their best interest. There isn’t a one size fits all approach, but I do think a debate is much needed.

Family and care of psychiatric patients

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